フククラ ヨシヒコ   Yoshihiko Fukukura
  福倉 良彦
   所属   川崎医科大学  医学部 臨床医学 機能・代謝画像診断学
   職種   教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 The value of intratumoral heterogeneity of (18)F-FDG uptake to differentiate between primary benign and malignant musculoskeletal tumours on PET/CT.
掲載誌名 正式名:The British journal of radiology
略  称:Br J Radiol
ISSNコード:1748880X/00071285
掲載区分国外
巻・号・頁 88,pp.20150552-20150552
著者・共著者 Masatoyo Nakajo, Masayuki Nakajo, Megumi Jinguji, Yoshihiko Fukukura, Yoshiaki Nakabeppu, Atsushi Tani, Takashi Yoshiura
発行年月 2015
概要 OBJECTIVE:The cumulative standardized uptake value (SUV)-volume histogram (CSH) was reported to be a novel way to characterize heterogeneity in intratumoral tracer uptake. This study investigated the value of fluorine-18 fludeoxyglucose ((18)F-FDG) intratumoral heterogeneity in comparison with SUV to discriminate between primary benign and malignant musculoskeletal (MS) tumours.METHODS:The subjects comprised 85 pathologically proven MS tumours. The area under the curve of CSH (AUC-CSH) was used as a heterogeneity index, with lower values corresponding with increased heterogeneity. As 22 tumours were indiscernible on (18)F-FDG positron emission tomography, maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean) and AUC-CSH were obtained in 63 positive tumours. The Mann-Whitney U test and receiver operating characteristic (ROC) analysis were used for analyses.RESULTS:The difference between benign (n = 35) and malignant tumours (n = 28) was significant in AUC-CSH (p = 0.004), but not in SUVmax (p = 0.168) and SUVmean (p = 0.879). The sensitivity, specificity and accuracy for diagnosing malignancy were 61%, 66% and 64% for SUVmax (optical threshold value, >6.9), 54%, 60% and 57% for SUVmean (optical threshold value, >3) and 61%, 86% and 75% for AUC-CSH (optical threshold value, ≤0.42), respectively. The area under the ROC curve was significantly higher in AUC-CSH (0.71) than SUVmax (0.60) (p = 0.018) and SUVmean (0.51) (p = 0.005).CONCLUSION:The heterogeneity index, AUC-CSH, has a higher diagnostic accuracy than SUV analysis in differentiating between primary benign and malignant MS tumours, although it is not sufficiently high enough to obviate histological analysis.ADVANCES IN KNOWLEDGE:AUC-CSH can assess the heterogeneity of (18)F-FDG uptake in primary benign and malignant MS tumours, with significantly greater heterogeneity associated with malignant MS tumours. AUC-CSH is more diagnostically accurate than SUV analysis in differentiating
DOI 10.1259/bjr.20150552
PMID 26337605